Individual
DR. MARYAM SHAMBAYATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3330 NW 56TH ST STE 500, OKLAHOMA CITY, OK 73112-4470
(405) 713-7060
(405) 713-7064
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 713-7060
(405) 713-7064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Q1300
TX
2080P0206X
Pediatric Gastroenterology Physician
Primary
5813
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30209771
TEXAS DPS
TX
Enumeration date
08/07/2012
Last updated
03/07/2023
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